Urine ALCAM, VCAM-1 and hemopexin surpassed conventional laboratory metrics (anti-dsDNA, C3 and C4) in detecting clinical disease activity among cSLE patients, whereas ALCAM, VCAM-1 and PF4 levels were the best discriminators of renal disease activity in cSLE patients, outperforming conventional biomarkers including proteinuria. Here, C4A is linked to kidney disorder.